Individual provider Active NPI

Laura Jane Kannaian, FNP-BC

  • Family Nurse Practitioner
  • Salt Lake City, UT
National Provider Identifier
1235655903
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
13123669-4405 Issued in UT
Practice address
117 W 400 S
Salt Lake City, UT 84101-1916
Phone
(801) 428-4257
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 13123669-4405 UT Primary

Addresses

Primary practice location

117 W 400 S
Salt Lake City, UT 84101-1916

Mailing address

117 W 400 S
Salt Lake City, UT 84101-1916
Phone (801) 428-4257

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250210002782 UT Practitioner - Nurse Practitioner 5092053157 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Odyssey House Inc CurrentSince Jan 1, 2025 Accepting new patients
Odyssey House Inc Current Accepting new patients
Integrative Womens Care PC Past Accepting new patients
Michelle Cooper NP LLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Orem Medical Properties LLC Past Accepting new patients

Locations

117 W 400 S
Slc, UT 84101
Phone (385) 200-0110

340 E 100 S
Slc, UT 84111
Phone (801) 322-3397

Interoperability endpoints

  • Direct secure messaging: laura.kannaian.1@12395.direct.athenahealth.com

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1235655903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011916",
            "telephone_number": "801-428-4257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 400 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841011916",
            "telephone_number": "801-428-4257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNAIAN",
        "first_name": "LAURA",
        "middle_name": "JANE",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "13123669-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.